Goodson NJ et al. (2005) Baseline levels of C-reactive protein and prediction of death from cardiovascular disease in patients with inflammatory polyarthritis. Arthritis Rheum 52: 2293–2299

A prospective single-center study has found a correlation between levels of C-reactive protein (CRP) measured at the time of diagnosis of inflammatory polyarthritis (IP) and death from cardiovascular disease (CVD). Goodson et al. had previously demonstrated increased CVD mortality rates in women with rheumatoid-factor (RF)-positive IP and aimed to extend this work by examining whether the level of CRP, a marker of inflammation, could independently predict CVD mortality rates in IP patients.

The group used data from death certificates to determine cause of death (median follow-up 10.1 years) for 506 patients recruited to an arthritis register between 1990 and 1992. Registered patients had definite inflammatory synovitis in two or more joints, lasting at least 4 weeks, and not subsequently explained by another, nonarthritic, diagnosis. Levels of CRP and RF were measured at baseline.

Multivariate analysis, adjusted for demographic and disease-related potential confounders, demonstrated that the presence of RF and a CRP level at or above 5 mg/l were strong and independent predictors of CVD mortality rates. Although comorbid CVD was defined by use of cardiovascular medication rather than assessed directly, the correlation between CRP level and CVD mortality rate was still present after adjusting for this factor.

Although the role of CRP in CVD is unclear, its identification as a predictive marker of CVD in patients with IP might allow better targeting of interventions for those at risk.